CIGARETTE-SMOKING AND BREAST-CANCER - A CASE-CONTROL STUDY OF SCREENING-PROGRAM PARTICIPANTS
CIGARETTE-SMOKING AND BREAST-CANCER - A CASE-CONTROL STUDY OF SCREENING-PROGRAM PARTICIPANTS
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DOI：
10.1093/oxfordjournals.aje.a114026
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发表时间：
1985-01-01
影响因子：
5
通讯作者：
HOWE, GR
中科院分区：
文献类型：
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作者：
SCHECHTER, MT;MILLER, AB;HOWE, GR
在一项多中心筛查计划中，对40-59岁的加拿大妇女（n = 123，369）进行了一项关于吸烟与初次就诊乳腺癌检测之间关系的病例对照研究。在绝经前妇女中，吸烟者与从不吸烟者的相对风险为2.1（1.1-4.0）。在接触0、1-200、201-500和> 500微克-年的妇女中，存在剂量-反应梯度，相对风险分别为1.0、1.3、2.5和3.5。在绝经后妇女中未检测到总体相关性，但在该组中存在与产次的显著相互作用。当忽略更年期状态时，曾经吸烟者与从不吸烟者的风险无显着升高，为1.4（0.9，2.1），但剂量反应显着，上述4种暴露类别的相对风险分别为1.0、0.9、1.7和2.0。尽管对几个重要变量进行了调整，但这些结果仍然存在。这些数据与吸烟和参与筛选研究的相互作用或吸烟的可能病因作用一致。即使吸烟与乳腺癌的病因学无关，这些数据仍然表明，访问筛查中心的吸烟者在首次访问时发现乳腺癌的风险增加，特别是在绝经前妇女中。他们不支持吸烟的保护作用的假设，并强调需要进一步研究这种重要的关系。
A case-control study of Canadian women aged 40-59 yr (n = 123,369) was conducted on the relationship of cigarette smoking and initial visit breast cancer detection within a multicenter screening program. Among premenopausal women, a relative risk of 2.1 (1.1-4.0) was found for ever-smokers vs. never-smokers. There was a dose-response gradient with relative risks of 1.0, 1.3, 2.5 and 3.5 among women with 0, 1-200, 201-500 and > 500 cigarette-years of exposure, respectively. No overall association was detected among postmenopausal women but a significant interaction with parity was present in this group. When menopausal status was ignored, there was a nonsignificantly elevated risk of 1.4 (0.9, 2.1) for ever- vs. never-smokers but the dose-response was significant with relative risks of 1.0, 0.9, 1.7 and 2.0 in the above 4 exposure categories, respectively. These results persisted despite adjustment for several important variables. These data are consistent with an interaction of smoking and participation in the screening study or with a possible etiologic role for smoking. Even if smoking is not related to breast cancer etiologically, these data still suggest that smokers who visit screening centers have an elevated risk of breast cancer detection on initial visit, especially among premenopausal women. They do not support the hypothesis of a protective effect of smoking and underscore the need for further study into this important relationship.